Osteoarthritis, or OA, is one of the most common chronic joint diseases in Australia, affecting around 1 in every 11 individuals , according to the Australian Institute of Health & Welfare, 2018. Unlike Rheumatoid Arthritis, Osteoarthritis is typically known as a ‘wear and tear condition’ and is thought to degenerate with overuse of joints or after an injury to the joint. It causes:
Damage to the cartilage in our bones (the smooth, strong surface that allows our joints to move easily)
Swelling and inflammation to the tissues surrounding our joints
Weakening and deterioration of the these surrounding structures, including muscles, ligaments and tendons
You can develop OA in any joint in your body; however it is quite common in the small joints of the hands as we use these frequently and intensively in daily life.
What Happens to Your Joints if you Have Osteoarthritis?
In a normal, healthy joint, a firm, rubber-like structure called cartilage covers the ends of each bone. Cartilage exists to provide a smooth, gliding surface for joints to move on one another. It also also acts as a ‘shock absorber’ for the bones, cushioning the blow of any force we put through them in daily life.
In an individual with OA, this cartilage begins to break down and wear away over time. This leaves the bony surfaces exposed and causes pain, swelling and difficulty moving the joints. As the condition worsens, the exposed bone can begin to deteriorate, forming sharp projections called bony ‘spurs’ (which you can often see sitting just under your skin) and even flaking off into the joint space itself. This can cause the body to go into ‘over-protect’ mode, kickstarting an inflammatory process and releasing more chemicals which actually further damage the cartilage and cause more pain.
Causes of Osteoarthritis:
There is research indicating certain risk factors that can contribute to the likelihood of developing OA. Those listed below are specific to risk factors for the hand and upper limb. There are other factors associated with developing OA elsewhere in the body.
Risk factors for upper limb OA:
Increasing age - more common in people aged 40 and over
Previous joint injuries and hand/upper limb trauma
Family history
Being overweight or obese
Repetitive movements (usually associated with a job or long term hobby)
Certain metabolic disorders such as hemochromatosis, and
Inflammatory conditions including Rheumatoid Arthritis
Symptoms of Osteoarthritis:
The symptoms of OA can vary between individuals and often depend on the stage at which your condition has progressed. Some common symptoms include:
Pain - can be achey or burning or sharp
Stiffness and difficulty moving the affected digits/joints
C ‘crackling’ or ‘popping’ sound when moving the joints
Swelling or firm bony projections surrounding your joints/knuckles
Reduced ability to perform important activities
With OA affecting the hands, fine motor tasks including eating, cutting, turning taps and writing can be painful and difficult to complete
Treatment
Unfortunately a misconception exists that the effects of OA are inevitable and a guaranteed consequence of ageing. For this reason, many people do not seek support or are not active in management of the condition, causing it to worsen over time. This can have huge repercussions on engagement in important work, social and family events!
It is important to understand that with the right support and knowledge, the effects of arthritis can be successfully managed. A Hand Therapist can work with you to increase your understanding and give you the tools to effectively manage your OA. Some techniques they may introduce include:
Heat therapy
Splinting/bracing
Compression therapy
Management of pain and inflammation
Joint movement
Strengthening exercises
Activity modification
Discovery and use of assistive tools and devices (if necessary)
The biggest preventative measure for stopping the progression of OA is behaviour change and activity modification. For this reason, your active participation in therapy is imperative for achieving good outcomes.
What Can You Do To Make It Better?
If you are experiencing OA, or suspect you are, there are many things you can begin to do to help manage symptoms, slow down the progression of the disease and encourage the cartilage to regrow. These include:
Stretching your joints gently
Using heat to warm up your hands (particularly in the morning)
Maintain a healthy weight
Take note of activities that hurt and work out a way to do them without it hurting - this could include making the handles on your tools fatter or softer
Consult a naturopath to see if there are supplements that would assist you such as turmeric
Consult a hand therapist to work together to prevent the condition from worsening and to encourage cartilage regrowth
Make an appointment with your Hand Therapist today to see what else we can do to help you on your road to pain-free, functional hands!
